DESCRIPTION (Adapted from the applicant's description): STDs including HIV infection are major health problems for women. Heterosexual contact is currently the largest exposure category for female adult/adolescent HIV infection cases. While the male condom is effective in protecting against HIV/STDs, some men are unwilling to use condoms and, due to gender-based power imbalances, some women are unable to negotiate use. Female-controlled methods that can be used without the male partner's knowledge are needed. Research on the vaginal diaphragm indicates that the diaphragm is effective in preventing some STDs and has advantages over other female-controlled methods. The proposed research will improve understanding of the acceptability of the diaphragm for the prevention of HIV/STDs. This three-year project consists of two studies that examine factors that may influence the probability that the diaphragm will be used. Method characteristics, user characteristics, relationship characteristics and the sociocultural context are hypothesized to influence diaphragm acceptability. The first study is a cross-sectional telephone survey with 548 women who are either current or former diaphragm users and 400 women who are users of contraceptive methods other than the diaphragm. The sample will be recruited from members of Kaiser Permanente Northwest Region. The second study, a multi-method study of young adult women at risk for HIV/STDs who have never used the diaphragm, will build on the findings from Study 1. A sample of 162 to 216 racially/ethnically diverse university women will be recruited to participate in focus groups about the diaphragm, complete questionnaires immediately before and after the focus group and be given coupons for free diaphragms that can be redeemed at their university student health center. The subgroup of women who redeem their coupons will participate in face-to-face interviews 1-2 months later and complete a self-administered questionnaire. Findings from the proposed research will inform the development of new female-controlled barrier methods that have characteristics similar to the diaphragm, stimulate research on the efficacy of the diaphragm for HIV prevention, and suggest strategies to improve the acceptability of the diaphragm among high risk women.